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Aortic dissection

Prevalence
Clinical features
Differential diagnosis
Investigations
Therapy
Prevention
Prognosis
Prevention

Give propranolol to patients c particularly with Marfan syndrome a .  

Initially 10 mg four times a day, and after 2 to 4 weeks titred so that heart rate is < 100 beats/min during exercise, or systolic interval increased by less than 30%. 

Why?

  • It slows aortic dilatation, though the effect on aortic dissection is unclear a
  • Adverse effects are common (heart block, lethargy, insomnia). a

Adverse effects on propranolol are common

Patient Treatment Comparison Outcome CER RRR
(95% CI)		 NNH
(95% CI)
Marfan syndrome a propranolol no therapy side-effects
at 		0% 87%
(27% to 100%) 		3
(2 to 7)
 

Expiry date: August 2004
Levels of Evidence used in grading these guides

Author   CM   Ball
Reviewer   M   Briggs
CAT Writers   CM   Ball , CJ   Wotton